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Hepatic TB and Fungal Infections
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Opportunistic infection of liver (± other viscera), usually by fungal or mycobacterial organisms

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Simon J et al: Echinocandins in invasive candidiasis. Mycoses. 56(6):601-9, 2013
                                              2. Yellapu RK et al: Education and Imaging. Hepatobiliary and pancreatic: Candida liver abscesses associated with endocarditis. J Gastroenterol Hepatol. 25(5):1017, 2010
                                              3. Kim HJ et al: Isolated perihepatic tuberculosis: imaging findings. Clin Radiol. 64(2):184-9, 2009
                                              4. Amarapurkar DN et al: Hepatobiliary tuberculosis in western India. Indian J Pathol Microbiol. 51(2):175-81, 2008
                                              5. Benedetti NJ et al: Imaging of hepatic infections. Ultrasound Q. 24(4):267-78, 2008
                                              6. Saluja SS et al: Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg. 7:10, 2007
                                              7. Masood A et al: Chronic disseminated candidiasis in patients with acute leukemia: emphasis on diagnostic definition and treatment. Leuk Res. 29(5):493-501, 2005
                                              8. Rudolph J et al: Unusual enhancement pattern of liver lesions in hepatosplenic candidiasis. Acta Radiol. 45(5):499-503, 2004
                                              9. Hanninen EL et al: Detection of focal liver lesions at biphasic spiral CT: randomized double-blind study of the effect of iodine concentration in contrast materials. Radiology. 216(2):403-9, 2000
                                              10. Wig JD et al: Cholangitis due to candidiasis of the extra-hepatic biliary tract. HPB Surg. 11(1):51-4, 1998
                                              11. Pestalozzi BC et al: Hepatic lesions of chronic disseminated candidiasis may become invisible during neutropenia. Blood. 90(10):3858-64, 1997
                                              12. Semelka RC et al: Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging. AJR Am J Roentgenol. 169(5):1311-6, 1997
                                              13. Giamarellou H et al: Epidemiology, diagnosis, and therapy of fungal infections in surgery. Infect Control Hosp Epidemiol. 17(8):558-64, 1996
                                              14. van Leeuwen MS et al: Focal liver lesions: characterization with triphasic spiral CT. Radiology. 201(2):327-36, 1996
                                              15. Lamminen AE et al: Infectious liver foci in leukemia: comparison of short-inversion-time inversion-recovery, T1-weighted spin-echo, and dynamic gadolinium-enhanced MR imaging. Radiology. 191(2):539-43, 1994
                                              16. Olcott EW et al: Polyarteritis nodosa mimicking hepatic candidiasis on postcontrast CT. J Comput Assist Tomogr. 18(2):305-7, 1994
                                              17. Semelka RC et al: Detection of acute and treated lesions of hepatosplenic candidiasis: comparison of dynamic contrast-enhanced CT and MR imaging. J Magn Reson Imaging. 2(3):341-5, 1992
                                              18. Meunier F: Candidiasis. Eur J Clin Microbiol Infect Dis. 8(5):438-47, 1989
                                              19. Cunha BA: Systemic infections affecting the liver. Some cause jaundice, some do not. Postgrad Med. 84(5):148-58, 161-3, 166-8, 1988
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Opportunistic infection of liver (± other viscera), usually by fungal or mycobacterial organisms

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Simon J et al: Echinocandins in invasive candidiasis. Mycoses. 56(6):601-9, 2013
                                                                                          2. Yellapu RK et al: Education and Imaging. Hepatobiliary and pancreatic: Candida liver abscesses associated with endocarditis. J Gastroenterol Hepatol. 25(5):1017, 2010
                                                                                          3. Kim HJ et al: Isolated perihepatic tuberculosis: imaging findings. Clin Radiol. 64(2):184-9, 2009
                                                                                          4. Amarapurkar DN et al: Hepatobiliary tuberculosis in western India. Indian J Pathol Microbiol. 51(2):175-81, 2008
                                                                                          5. Benedetti NJ et al: Imaging of hepatic infections. Ultrasound Q. 24(4):267-78, 2008
                                                                                          6. Saluja SS et al: Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg. 7:10, 2007
                                                                                          7. Masood A et al: Chronic disseminated candidiasis in patients with acute leukemia: emphasis on diagnostic definition and treatment. Leuk Res. 29(5):493-501, 2005
                                                                                          8. Rudolph J et al: Unusual enhancement pattern of liver lesions in hepatosplenic candidiasis. Acta Radiol. 45(5):499-503, 2004
                                                                                          9. Hanninen EL et al: Detection of focal liver lesions at biphasic spiral CT: randomized double-blind study of the effect of iodine concentration in contrast materials. Radiology. 216(2):403-9, 2000
                                                                                          10. Wig JD et al: Cholangitis due to candidiasis of the extra-hepatic biliary tract. HPB Surg. 11(1):51-4, 1998
                                                                                          11. Pestalozzi BC et al: Hepatic lesions of chronic disseminated candidiasis may become invisible during neutropenia. Blood. 90(10):3858-64, 1997
                                                                                          12. Semelka RC et al: Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging. AJR Am J Roentgenol. 169(5):1311-6, 1997
                                                                                          13. Giamarellou H et al: Epidemiology, diagnosis, and therapy of fungal infections in surgery. Infect Control Hosp Epidemiol. 17(8):558-64, 1996
                                                                                          14. van Leeuwen MS et al: Focal liver lesions: characterization with triphasic spiral CT. Radiology. 201(2):327-36, 1996
                                                                                          15. Lamminen AE et al: Infectious liver foci in leukemia: comparison of short-inversion-time inversion-recovery, T1-weighted spin-echo, and dynamic gadolinium-enhanced MR imaging. Radiology. 191(2):539-43, 1994
                                                                                          16. Olcott EW et al: Polyarteritis nodosa mimicking hepatic candidiasis on postcontrast CT. J Comput Assist Tomogr. 18(2):305-7, 1994
                                                                                          17. Semelka RC et al: Detection of acute and treated lesions of hepatosplenic candidiasis: comparison of dynamic contrast-enhanced CT and MR imaging. J Magn Reson Imaging. 2(3):341-5, 1992
                                                                                          18. Meunier F: Candidiasis. Eur J Clin Microbiol Infect Dis. 8(5):438-47, 1989
                                                                                          19. Cunha BA: Systemic infections affecting the liver. Some cause jaundice, some do not. Postgrad Med. 84(5):148-58, 161-3, 166-8, 1988